[Circadian rhythm of autonomic heart activity in patients with primary essential hypertension treated with angiotensin converting enzyme inhibitor]. / Cyklicznosc dobowa aktywnosci ukladu autonomicznego serca u chorych z pierwotnym nadcisnieniem tetniczym leczonych inhibitorem enzymu konwertujacego angiotensyne.

UNLABELLED: Although the immediate effects of angiotensin converting enzyme inhibitors (ACEI) on cardiac autonomic innervation have been extensively studied, little is known about circadian rhythm of heart rate variability (HRV) in these patients. The purpose of the present study was to investigate circadian changes of the autonomic activity in patients with essential hypertension treated with ACEI, which may play some role in the pathogenesis of hypertension. We studied 10 middle age patients with essential hypertension (treated with ACEI--enarenal at least 1 yr.) and 10 age, gender matched control subjects. Heart rate variability (HRV) was calculated from the 24-hr ambulatory electrocardiograms by the Fourier transformation. Power spectra were quantified at 0.003-0.04 Hz--very low frequency power (VLF), 0.04-0.15 Hz--low frequency power (LF) and 0.15-0.40 Hz--high frequency power (HF). The HF component and the ratio LF to HF were used as indices of the parasympathetic activity and balance between sympathetic and parasympathetic activities. RESULTS: The circadian rhythms of the LF, HF and LF/HF ratio differed significantly. In control group, LF, HF increased but LF/HF decreased (p < 0.05) at night, in hypertensive patients LF, HF increase was attenuated at night but LF/HF increased (p < 0.05). In control subjects when compared to hypertensive patients power spectrum HF was doubled at night. CONCLUSION: These findings suggest that in hypertension primary cardiac autonomic dysfunction might contribute to altered circadian rhythm leading to the development of cardiovascular diseases despite long term normalisation of high blood pressure.

[The effect of chronic alcohol use on heart rate variability]. / Wplyw przewleklego spozycia alkoholu na zmiennosc rytmu zatokowego serca.

A long lasting alcohol intake causes, amongst numerous systemic damages, also the autonomic nervous system (ANS) dysfunction, which causes the autonomic heart rate regulation disorders. The aim of the study was to evaluate the autonomic regulation of the circulation in chronic alcoholism. Seventeen alcoholics, 24-55 years of age (mean 43 +/- 5.2 years) were examined. They have been abstainers for 2-6 years. The cardiac ANS function was evaluated using the HRV measurement. The HRV was registered using V6 EKG lead. The recording was performed through the 15 min of resting conditions and 5 min of the deep breathing test. A group containing healthy volunteers, matched for age and gender, for the comparison of the HRV results was recruited. In the examined group, during the resting conditions, the significant RR period changes weren't observed (999.7 +/- 139.2 vs. 967 +/- 144.9; p > 0.05). The nonsignificant lower values of the spectral analysis parameters of HRV: LF (954.1 +/- 1162.6 vs. 1456.4 +/- 1327.1; p > 0.05) and HF (676.4 +/- 414.2 vs. 1557 +/- 1854.4; p > 0.05) and LF/HF ratio (1.5 +/- 1.14 vs. 1.38 +/- 1.28; p > 0.05) were also noticed. In response to the DB test, the mean value of the RR period wasn't significantly changed (921.4 +/- 152.3 vs. 930.6 +/- 137.8; p > 0.05). In DB test the significant decrease of LF (3465.8 +/- 2750.1 vs. 11558.6 +/- 7902.5; p < 0.001) and HF (406.1 +/- 366.8 vs. 1665 +/- 1757.1; p < 0.01) was observed. No significant change of LF/HF mean ratio (11.6 +/- 6.97 vs. 14.7 +/- 11.6; p > 0.05) was noticed. The results of our study indicate on the maintenance of the HRV disorders in chronic alcoholics, during the abstinence.

[The role of the autonomic nervous system on malfunction of gastric motor and myoelectric activity in patients with hyperthyroidism]. / Rola ukladu autonomicznego w zaburzeniach czynnosci motorycznej i mioelektrycznej zoladka u chorych z nadczynnoscia tarczycy.

The aim of this study was to determine both the type of gastric mioelectric and emptying disorders in correlation to degree of severity of hyperthyroidism (clinical and thyroid hormones' blood levels) and ANS function estimated in HRV analysis. The study was performed on a group of 50 patients (35 with multinodular toxic goitre and 15 with Graves' disease, 45 females and 5 males, mean age 39.6 years, mean BMI 23.72) with newly diagnosed and so far untreated hyperthyroidism. The control group were 50 healthy volunteers age-, sex-, and BMI-matched to the studied group. Patients were studied twice, within newly diagnosed thyreotoxicosis and after treatment (Metizol) and reaching stable euthyroid state. The study consisted of: a) percutaneous EGG analysis (Synectics): 30 minutes before and after a test meal (ENRICH Liquid 250 ml), b) HRV analysis (ECG POSTER 2002): 10 minutes at rest and during deep breathing test, c) ultrasound measurement of gastric emptying by Bolondi method. Statistical analysis of collected data was performed. In hyperthyroid patients significant both preprandial and postprandial dysrhythmia (33.01% of bradygastria and 16.49% of tachygastria) was found. In some patients decrease of amplitude of EGG signal was marked as a result of antral hypomotility with coexisting significantly prolonged gastric emptying (110 min). Among severe hyperthyroid patients both the antral food distribution (antrum 35% bigger than in a control group) and impaired proximal stomach relaxation were evident. The degree of gastric mioelectric activity and emptying disorders was proportional to the degree of both severity of clinical manifestation of hyperthyroidism in Zgliczynski scale (from I degree to III degrees) and free thyroid hormones' blood levels (positive correlation). In HRV analysis at rest in hyperthyroid patients comparing to a control group the decrease of both the heart rate variability and a total power was found particularly in HF component resulting in relative sympathetic activation. In HRV analysis during deep breathing test the decrease of heart rate variability was present mostly in LF component. It indicates on reduction of vagal regulation (and vagal excitability) of sinus node and gastric pacemaker function. Coexistence of the increase and decrease of a gastric basic electrical rhythm with delay of gastric emptying indicates on a complex mechanism of their formation. Both neurogenic regulation dysfunction and primary miogenic autoregulation disorders as a result of tyreotoxicosis seem to be the possible causes. All the found changes were functional and disappeared after reaching the stable euthyroid state within 3 months of pharmacological treatment.

[Value of electrogastrographic parameters in evaluation of gastric myoelectrical activity]. / Wartosc parametrów elektrogastrograficznych w ocenie czynnosci mioelektrycznej zoladka.

Electrogastrography (EGG) is presently the only non-invasive method for the evaluation of gastric myoelectrical activity. In relation to the more and more described disturbances of the basic electrical rhythm in different pathological units EGG has been applied on a still larger scale. However, the data obtained from the EGG record do not reflect directly the gastric motility. This method allows only to make an indirect evaluation of the gastric motor disturbances. It still entails a great number of investigations so as to attain a better precisions of the evaluations of its clinical usefulness in gastroenterological diagnostics. This thesis presents the basic information on the methodology, the parameters under evaluation and the clinical application of the EGG method.

[The influence of aging on autonomic nervous system activity and gastric myoelectric activity in humans]. / Wplyw procesu starzenia na aktywnosc ukladu autonomicznego i mioelektryczna zoladka u ludzi.

The study was performed on 84 healthy volunteers (33 women, 52 men) of age 20-71 years with no history of the circulatory or gastrointestinal system disease. The gastric myoelectrical activity (EGG) was recorded with the cutaneous electrodes--electrogastrography Synectics (Sweden). The activity of the cardiac autonomic nervous system was measured by HRV (heart rate variability) recorded with EGG and computer assisted programme Proster (Poland). Subject were divided into 5 groups according to the decade of age (20-70). Percentage of basal electrical rhythm (BER) dysrhythmias increased (1.9 +/- 0.5% vs 21.1 +/- 3.2% in fasting and 2.4 +/- 1.2% vs 24.6 +/- 5% postprandially but decrease of the EGG amplitude after the meal was observed (270 +/- 20% vs 90 +/- 7%) in youngest and oldest group respectively. With the ageing the cardiac sympathetic and parasympathetic activity (LF and HF) decreased in first and last group respectively. In the forth decade in man and women the sympathetic activity system prevalence expressed by the LF/HF rate increased (1.09 +/- 0.2 vs. 2.14 +/- 0.5) (p < 0.05). The results of our study suggest the deleterious influence of the ageing on the of autonomic system activity as shown by changes in HRV and dysrhythmia of the gastric slow waves in EGG.

[Autonomic nervous system and gastric myoelectric activities in type 1 and type 2 diabetes]. / Aktywnosc autonomicznego ukladu nerwowego a czynnosc mioelektryczna zoladka w cukrzycy typu 1 i 2.

The aim of the study was to compare autonomic function and gastric myoelectric activity in patients with type 1 and 2 of diabetes. We used the skin electrodes for recording gastric myoelectric activity (EGG) and the heart rate variability (HRV). Patients were divided into two groups. The first group: 19 patients with IDDM. The second-16 patients with NIDDM. We made two comparative control groups, matched with age and gender. We conclude, that decrease in gastric myoelectric activity was observed in both groups of patients, mostly in 1 group (IDDM) of patients. There was increase of heart rate and reduction of spectral analysis parameters in both types of diabetic. In patients with type 1 we noticed the increase of sympathetic activity (LF/HF ratio increased). In patients with type 2 there was the non significant decrease in sympathetic activity (LF/HF ratio decreased). On the basis of our observations we confirmed the correlation among autonomic function tested by HRV and changes of stomach electric activity. Decrease in HRV and gastric myoelectric activity could be indicating damage of parasympathetic system in IDDM.